Provider Demographics
NPI:1225891245
Name:ESTEVIS, CANDACE ANN (PA-C)
Entity Type:Individual
Prefix:
First Name:CANDACE
Middle Name:ANN
Last Name:ESTEVIS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4126 CHRIS DR
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79606-5536
Mailing Address - Country:US
Mailing Address - Phone:940-447-7521
Mailing Address - Fax:
Practice Address - Street 1:2074 ANTILLEY RD
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79606-5209
Practice Address - Country:US
Practice Address - Phone:325-698-3865
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-01
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA17577363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant